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Crafting Care that Fits: Workload and Capacity Assessments Complementing Decision Aids in Implementing Shared Decision Making
Thomas H. Wieringa;
Manuel F. Sanchez-Herrera;
Nataly R. Espinoza Suarez;
Viet-Thi Tran;
Kasey Boehmer
ABSTRACT
About 42% of adults have a chronic condition and 23% multiple chronic conditions. The coordination and integration of services for the management of patients living with multimorbidity is important for care to be efficient, safe, and less burdensome. Minimally Disruptive Medicine may optimize this coordination and integration, and is a patient-centered approach to care that focuses on achieving patient goals for life and health by seeking care strategies to fit patient context that are minimally disruptive and maximally supportive. The Cumulative Complexity Model practically orients Minimally Disruptive Medicine-based care. In this model, the patient workload-capacity imbalance is the central mechanism driving patient complexity. These elements should be accounted for when making decisions for patients with chronic conditions. Therefore, in addition to decision aids which may guide Shared Decision Making, we propose to systematically clarify a potential workload-capacity imbalance.